crossing96/oncoscreening huggingface dataset:
Aortic complications after treatment with bacillus Calmette-Guérin: a tertiary hospital experience and an update of the literature.	BACKGROUND: Intravesical instillation of bacillus Calmette-Guérin (BCG) is currently the gold standard for treating non-muscle-invasive bladder cancer (NMIBC). Vascular complications following bladder instillations, including the development of mycotic aneurysms, are extremely rare. This study aims to report six cases of mycotic aneurysm following intravesical BCG instillations and to review the relevant literature. METHODS: We present a case series of six patients with mycobacterial aortic infections related to BCG treatment, managed at our hospital between 2017 and 2023, following the PROCESS (Preferred Reporting of Case Series in Surgery) guidelines. Additionally, a literature review was conducted using major international databases (PubMed, Scopus, and EMBASE). RESULTS: A total of 74 patients with aortic lesions following intravesical BCG instillation have been reported in the literature. All patients were male (74/74), with a mean age of 72±7 years. The demographic characteristics in our series were similar. In five of our six cases (83.3%), the infection involved the thoracic or thoracoabdominal aorta. The mean time from the first BCG instillation to the development of a mycotic aneurysm was 15±2 months in the literature, whereas in our experience it was 26 months. Overall, open surgical repair was the definitive treatment in 71.6% of patients, whereas in our series the rate was 83.3%. Major postoperative complications included bleeding (2.7%), multi-organ failure (4%), and reinfection (4%). The overall 30-day mortality rate was 9.4%, in our series was 16.6% (one case). All surviving patients initiated multidrug antitubercular therapy. CONCLUSIONS: Although extremely rare, mycotic aneurysms related to intravesical BCG instillation can develop months to years after treatment. Diagnosis requires a high index of suspicion due to nonspecific symptoms. Both prosthetic and biological grafts yielded favorable outcomes regarding early mortality and morbidity. Postoperative multidrug antitubercular therapy appears essential following surgical repair.	bladder
Circ_0003266 suppresses bladder cancer progression by modulating the miR-503-5p/SMAD7/TGF-β signaling axis.	Circular RNAs (circRNAs) have emerged as critical regulators in cancer progression. This study aimed to investigate the role of circ_0003266 in bladder cancer (BCa) and elucidate its underlying molecular mechanisms. The expression levels of circ_0003266, miR-503-5p, and SMAD7 in BCa tissues and cell lines were determined using bioinformatics analysis, clinical data, and quantitative real-time PCR (qPCR). Cellular phenotypes were evaluated through proliferation, migration, and apoptosis assays. RNA pull-down and luciferase reporter assays were conducted to validate the molecular interactions among circ_0003266, miR-503-5p, and SMAD7. The involvement of the TGF-β signaling pathway was assessed by Western blotting and co-immunoprecipitation (Co-IP) analysis. Circ_0003266 expression was significantly downregulated in BCa tissues and cell lines, and its low expression was clinically correlated with larger tumor size and advanced disease stage, including poor differentiation and higher TNM classification. Upregulation of circ_0003266 inhibited BCa cell proliferation and migration while promoting apoptosis. Mechanistic analyses revealed that miR-503-5p is a direct target of circ_0003266, and that circ_0003266-mediated regulation of miR-503-5p subsequently modulates SMAD7 expression. SMAD7, a well-established inhibitor of the TGF-β pathway, was shown to mediate the tumor-suppressive effects of circ_0003266. In vivo experiments confirmed that overexpression of circ_0003266 attenuated tumor growth and suppressed TGF-β signaling activity. Our findings demonstrate that circ_0003266 exerts tumor-suppressive functions in BCa by modulating the miR-503-5p/SMAD7/TGF-β axis, highlighting its potential as a novel therapeutic target for bladder cancer intervention.	bladder
Bladder surface-based analysis proves the advantages of online adaptive radiotherapy over plan of the day.	BACKGROUND: Radiotherapy delivery for bladder cancer is challenging due to inter- and intra-fraction anatomical variations. The literature shows that surface-based methods, such as cumulative Dose-Surface Histograms (cDSHs), are more appropriate than dose-volume histograms for evaluating dose distribution in hollow organs. PURPOSE: To compare two adaptive radiotherapy approaches - Plan of the Day (POD) and online-Adaptive Radiotherapy (oART) - by focusing on target coverage, dose conformity, and healthy tissue sparing through surface-based methods. METHODS: Five patients with urothelial bladder cancer were selected. POD and oART treatment (9-field-IMRT plans, 55 Gy/20 fractions) were simulated using the Ethos™ Emulator. The cDSHs were compared using the D98% and D50% metrics, describing the dose covering 98% and 50% of the PTV/CTV surface, respectively. The Surface Distance Histogram (SDH) was introduced and analysed through Full Width at Half Maximum and mode value. The Healthy Tissue Overdose volume Factor (HTOF) at 95% and 50% isodoses was calculated. Statistical comparisons included the Friedman test and the Canberra dissimilarity index. RESULTS: oART achieved superior PTV coverage, with a mean D98% consistently above 98% of the prescribed dose, whereas for POD, the mean D98% dropped below 90% for two patients. oART SDHs showed narrower bell shape with respect to POD, indicating higher dose conformity. oART improved healthy tissue sparing, reducing HTOF(95%) by over 50% compared to POD. Inter- and intra-patient variability were lower for oART. CONCLUSIONS: Surface analysis strengthens the notion that oART is advantageous in bladder cancer treatment, ensuring superior target coverage, enhanced dose conformity, and better healthy tissue sparing. The SDH findings suggest potential for reducing CTV-PTV margins.	bladder
Bisphenol A exposure promotes proliferation and invasion capabilities of bladder cancer cells: Insights from gene expression and pathway analysis.	Bisphenol A (BPA), a synthetic organic compound widely used in plastic products, toys, water pipes, and flame retardants, has been linked to the onset and progression of various cancers. This study explores the association between BPA and bladder cancer using bioinformatics approaches. We applied the ssGSEA algorithm to calculate BPA-related scores in TCGA-BLCA cohort and classify patients based on this. GO and KEGG pathway enrichment analyses identified key pathways associated with BPA-related genes. Prognostic genes were screened through differential expression, Cox regression, and Lasso regression, leading to the construction of a prognostic model. Pathway enrichment suggested that BPA exposure promotes bladder cancer progression by modulating the Epithelial-Mesenchymal Transition pathway. In vitro experiments demonstrated that exposure to 10⁻⁷ μM BPA significantly enhanced the proliferation and invasion of bladder cancer cells, with Western blot confirming that BPA induces the EMT phenotype in a dose-dependent manner. These findings suggest the involvement of the BPA-mediated regulatory network in bladder cancer progression, thereby providing novel insights into the molecular mechanisms underlying BPA-induced bladder cancer development upon environmental exposure.	bladder
Cancer-specific mortality in secondary bladder cancer after nephroureterectomy for upper tract urothelial carcinoma.	OBJECTIVE: To examine differences in cancer-specific mortality (CSM) in nonmetastatic upper tract urothelial carcinoma (UTUC) patients with vs. without secondary bladder cancer (BCa) after radical nephroureterectomy (RNU). METHODS: Within the Surveillance, Epidemiology, and End Results database (SEER 2000-2021), T1-T4N0M0 UTUC patients treated with RNU and diagnosed with secondary BCa were identified. A landmark approach was used, requiring the diagnosis of secondary BCa within 18 months of the UTUC diagnosis. Additionally, a minimum follow-up of 18 months after the UTUC diagnosis was required. Subsequently, Kaplan-Meier plots and time-dependent multivariable Cox regression (MCR) models were fitted. Sensitivity analyses were performed in patients with late BCa diagnoses (6 to 18 months after UTUC diagnosis). RESULTS: Of 3,013 eligible UTUC patients who fulfilled the landmark and follow-up criteria, 269 (9.0%) harbored secondary BCa. Ten-year CSM-free survival rates were respectively 60 vs 73% in patients with vs without secondary BCa. In MCR models, secondary BCa independently predicted higher CSM (hazard ratio [HR]: 1.53, p < 0.001). Subgroup analyses by tumor stage confirmed the independent predictor status of secondary BCa in T1-T2 stages (HR: 2.04, p < 0.001), primary renal pelvic (HR: 1.47, p = 0.003) and ureteral (HR: 1.63, p = 0.01) UTUC. Sensitivity analyses confirmed the independent predictor status of secondary BCa also in patients with late secondary BCa (HR: 1.68, p < 0.001). CONCLUSION: In general, secondary BCa in UTUC patients treated with RNU is associated with higher CSM. This disadvantage primarily affects patients with T1-T2 stage UTUC involving the ureter or renal pelvis.	bladder
Deep learning-driven whole-slide image analysis predicts chemo-resistance and motility subtypes in muscle-invasive bladder cancer.	BACKGROUND: Muscle-invasive bladder cancer (MIBC) is a clinically aggressive and heterogeneous disease with variable treatment responses. Transcriptome-based classifications, such as the Chemoresistance-Motility (CrM) signature, are valuable for understanding therapeutic resistance, but their clinical use is often hindered by high cost and tissue requirements. This study explores an alternative, scalable approach using deep learning analysis of whole slide images (WSIs). OBJECTIVE: We aimed to evaluate whether patch-level predictions from deep learning models applied to WSIs can accurately predict transcriptome-derived CrM subtypes and reflect tumor microenvironment (TME) characteristics in MIBC. METHODS: We analyzed 192 WSIs from 152 TCGA-BLCA patients. A pretrained deep learning model (densenet169-kather100k) was used to classify eight distinct tissue types per patch. A key histological metric, the SAM-to-DNT ratio, which represents the ratio of stromal, adipose, and smooth muscle (SAM) tissue types to debris, normal, and tumor epithelium (DNT) tissue types, was derived from these proportions. A random forest model was then trained on these features to predict CrM subtypes. RESULTS: The WSI-derived SAM-to-DNT ratio showed a strong positive correlation with the CrM score (R = 0.453) and transcriptome-based TME scores, such as cancer-associated fibroblasts (R = 0.398). Our random forest model successfully classified CrM subtypes with a balanced accuracy of 0.75, outperforming other algorithms. Feature importance analysis identified adipose tissue (ADI) and tumor epithelium (TUM) as the most predictive features for CrM status. CONCLUSIONS: Deep learning analysis of routine histological WSIs can serve as a practical, low-cost surrogate for molecular profiling, effectively capturing transcriptomic subtypes associated with chemoresistance in MIBC. This approach provides a viable method for patient stratification and establishes a foundation for future multi-modal precision oncology applications.	bladder
The clinical value of the EpCAM biomarker and its association with immune cell infiltration in bladder cancer.	BACKGROUND: Bladder cancer is characterized by its heterogeneous nature and high propensity for recurrence and progression. The absence of reliable diagnostic and prognostic biomarkers to accurately identify high-risk patients further complicates the clinical management of the disease. MOC-31, an antibody that targets epithelial cell adhesion molecule (EpCAM), is utilized to distinguish between mesothelioma and metastatic cancer, but its clinical utility, prognostic value and functional dynamics in bladder cancer have yet to be verified. METHODS: A comprehensive analysis of EpCAM expression and its associations with key clinicopathological parameters was performed via The Cancer Genome Atlas (TCGA). Additionally, we retrospectively assessed EpCAM expression in our bladder cancer cohort using MOC-31 antibody and examined its prognostic value and correlation with clinicopathological features. The cBioPortal, STRING and TIMER databases were used to explore the interactions between EpCAM expression, immune cell infiltration and immune checkpoint genes. RESULTS: The difference in EpCAM expression varied widely across various cancer types and was strongly correlated with advanced cancer stage. EpCAM staining with MOC-31 exhibited membranous positivity in 51.7% of the analysed cohort. Kaplan-Meier survival analysis revealed a discernible trend suggesting a poorer prognosis for patients with low EpCAM expression than for those with high EpCAM expression. Protein-protein interaction demonstrated that EFGR, HER2 and Claudin-7 are key EpCAM interactors. A strong association was observed between EpCAM expression and immune cell infiltration as well as immune-related genes. CONCLUSION: This study highlights the prognostic value of EpCAM in bladder cancer, revealing a strong link between EpCAM expression and disease pathogenesis. These results underscore the need for further research to validate these findings and explore the significance of EpCAM as a therapeutic target in managing bladder cancer.	bladder
SWI/SNF complex alterations predict immunotherapy response in bladder cancer.	BACKGROUND: Immune checkpoint inhibitors have revolutionized the treatment of urothelial bladder cancer (UBC), yet response remains limited to a subset of patients. The SWItch/sucrose non-fermentable (SWI/SNF) chromatin remodeling complex is recurrently altered across cancers, but its prevalence, functional impact, and predictive value in UBC remain unclear. This study aimed to comprehensively delineate the mutational spectrum of SWI/SNF genes in UBC and assess their utility as predictive biomarkers for response to immune checkpoint blockade. METHODS: We analyzed tumor specimens from 49 patients in the Daping Cohort and integrated data from five independent public cohorts comprising 2,280 cases in total. Somatic alterations were identified using targeted or whole-exome sequencing, and transcriptomic profiles were obtained from RNA sequencing datasets. Survival outcomes were evaluated using Kaplan-Meier survival analysis and time-dependent ROC curves. Tumor immune landscape was characterized via xCell-based deconvolution and corroborated by multiplex immunofluorescence on institutional samples. Prognostic modeling was performed across 65 machine-learning configurations, encompassing survival SVM, CoxBoost, and stepwise Cox, with external validation in independent cohorts. RESULTS: SWI/SNF alterations were present in 42.8% of UBCs, with the highest frequencies in ARID1A, ARID1B, ARID2, SMARCA4, and PBRM1. Tumors harboring these alterations displayed higher tumor mutational burden, increased neoantigen load, an immune-inflamed microenvironment, and a significantly improved overall survival following immune checkpoint blockade (p < 0.05). Genotype-specific models achieved strong prognostic discrimination (C-index > 0.75), with AUCs up to 0.909 in SWI/SNF-mutant and 0.772 in wild-type tumors, substantially outperforming single-modality biomarkers. CONCLUSIONS: SWI/SNF alterations define an immunotherapy-responsive stratification of UBC. The accompanying genotype-specific prognostic models provide a ready-to-test framework for guiding precision immunotherapy.	bladder
Unveiling novel bladder cancer associations from multicentred primary and secondary care electronic health records by machine learning: a case-control study.	OBJECTIVE: The rising incidence and mortality in bladder cancer (BC) underscore the importance of identifying asscociated features. Current reliance on haematuria as a primary indicator for BC proves inadequate. While mining electronic health records (EHRs) offer potential of identifying BC-related signals, traditional data-driven methods struggle with high-dimensional datasets. This study aims to uncover novel BC-associated clinical signals by developing Parsimony-driven cAtegory-balaNced binary Signal extractor for Primary Care EHRs (PanSPICE) tailored to extremely high-dimensional data linked from multi-centres. METHODS: We collected BC cases and control patients (n = 64,884) linked at patient-level from Welsh nationwide databases, yielding 48,261 features in primary care settings. The PanSPICE approach begins with information gain to pre-rank features, then applies Retentive Stickiness Binary Particle Swarm Optimisation (RSBPSO) combined with C5.0 classification tree to overcome computational barriers in feature selection. A two-layer optimisation treated clinical signals in care processes (POC), diagnoses (DIAG), and medications (MED) separately to prevent feature masking. A tailored fitness function for RSBPSO to simultaneously optimise model performance and feature sparsity. Associations of the selected features were interpreted using logistic regression models adjusted for deprivation indices. RESULTS: The PanSPICE identified 38 optimal features (AUC (area under the curve) = 0.81, 95 % CI: 0.80-0.82), including urinary tract infections (OR = 2.19, 95 % CI: 2.05-2.14) and inverse associations with stroke (OR = 0.64, 95 % CI: 0.54-0.74) and dementia (OR = 0.25, 95 % CI: 0.17-0.35). Gender stratification revealed female-specific urine glucose testing association (OR = 1.24, 95 % CI: 1.08-1.43). Certain medications, such as trimethoprim, were positively associated with BC, while others, including ramipril and prednisolone, showed protective effects. CONCLUSION: The PanSPICE enables efficient high-dimensional EHR analysis, revealing under-recognised potential BC risk profiles and protective comorbidities. Gender-specific differences in BC associations highlight the importance of gender-stratified analyses, while computational advances provide a template for EHR-based clinical discovery. Findings warrant further mechanistic research into neurological protective pathways.	bladder
Alantolactone curbs the malignant progression of bladder cancer partly via the HSP90AB1/LRP5/β-catenin axis.	Bladder cancer (BCa) represents a global health problem. Traditional Chinese medicine has a long history of treating cancers. This study has been conducted to illustrate the anti-cancer effects of alantolactone (ALT) in BCa and to explore the potential mechanism. The effects of ALT on the malignant behavior of T24 and TCCSUP cells were investigated. Bioinformatic methods were utilized to predict potential targets of ALT. Cells were infected with lentiviral overexpression vectors for heat shock protein HSP 90-beta (HSP90AB1) or treated with the β-catenin signaling inhibitor MSAB to explore their effects on BCa cell behaviors. The effects on tumorigenesis were also analyzed in a xenograft tumor model. ALT markedly reduced the proliferation, migration, and invasion of BCa cells and induced apoptosis. ALT treatment was associated with decreased HSP90AB1 levels in BCa cells and increased low-density lipoprotein receptor-related protein 5 (LRP5) ubiquitination, thereby impairing β-catenin activation. HSP90AB1 overexpression attenuated the anti-cancer effects of ALT, while MSAB repressed the malignant progression of BCa cells promoted by HSP90AB1 overexpression. Forced overexpression of HSP90AB1 enhanced BCa development in vivo, which was mitigated by MSAB. In conclusion, our findings suggest that ALT exerts anti-cancer activity in BCa, potentially through modulation of HSP90AB1 and β-catenin signaling pathways.	bladder
Zebrafish Xenograft Model for Predicting Cisplatin Efficacy in Muscle-Invasive Bladder Cancer.	The standard treatment for muscle-invasive bladder cancer (MIBC) is cisplatin (CDDP)-based neoadjuvant chemotherapy (NAC) followed by radical cystectomy. However, only about 40% of patients respond to NAC, and tools to predict individual responses remain limited. The zebrafish patient-derived xenograft (zPDX) model offers a rapid and cost-effective platform for functional drug testing, but its application to MIBC has not yet been established. In this study, we developed a zPDX model optimized for evaluating CDDP sensitivity using clinical bladder cancer specimens. This model was validated through three steps: (1) evaluation of CDDP response in zPDXs derived from cell lines, (2) comparison of drug responses between mouse PDX (mPDX) and zPDX models, and (3) correlation of zPDX responses with clinical outcomes. The robustness of step 1 was demonstrated through complementary assays, including temperature optimization, in vivo platinum quantification, fluorescent dye validation, Cap Analysis of Gene Expression (CAGE), and whole-mount immunofluorescence. An image-based platform for quantifying drug response by measuring fluorescent area was established and applied in steps 2 and 3. Step 2, using mPDXs, provided essential technical validation before applying the protocol to clinical samples. In step 3, patient-derived tumors were transplanted into zebrafish, allowing successful prediction of CDDP efficacy. Despite the small patient cohort, this study provides fundamental evidence supporting zPDX as a clinically relevant and experimentally validated tool for functional assessment of CDDP sensitivity in bladder cancer.	bladder
Functional and urodynamics outcomes after robot-assisted cystoprostatectomy with intracorporeal neobladder: Impact of the learning curve.	INTRODUCTION: Robotic-assisted radical cystectomy (RARC) with intracorporeal orthotopic neobladder (iONB) is a technically demanding procedure with a steep learning curve. This study aims to evaluate the functional and urodynamic outcomes of iONB during the initial learning phase to understand its impact on patient quality of life and surgical performance. METHODS: A retrospective cohort study was conducted at a high-volume tertiary center, analyzing 20 male patients who underwent RARC with iONB for bladder cancer between 2016 and 2021. Data collected included perioperative outcomes, complications, continence rates, and urodynamic parameters. Functional outcomes were assessed using patient questionnaires, and urodynamic assessments were performed on a subset of patients. RESULTS: The median follow-up was 23.8 months, and 75% of patients achieved continence (0-1 pad/day). None required self-catheterization, and urodynamic studies in four patients showed favorable capacity of 412.5mL (IQR: 360-512), with a median post-void residual of 5mL. Low-grade complications occurred in 65% of patients, while high-grade complications were observed in 35%. No intraoperative complications or conversions to open surgery were reported. CONCLUSION: RARC with iONB provides promising functional outcomes in the early learning phase. Further research with larger cohorts and controlled designs is needed to confirm these findings and optimize technique selection.	bladder